M A Gok, S J Ward, M M Sadat, U A Khan. Macclesfield District General Hospital
Intoduction Colorectal cancer is the 3rd most commonest maligancy in men & woemn in the UK. representing 13% of all new cancers in 2010. Right sided cancers (appendic, caecum, ascending & transverse colon) contribute to a 3rd of colorectal maligancies. The aim of the study is to assess right hemicoloectomies carried out at a district general hospital.
Materials & Methods This is a retospective study carried out since 2008 at Macclesfiedl District Genereal Hospital. Descriptive demography, co-morbidities,histopathology & surgical outcomes were evaluated for all right hemicolectomies (laparoscopic, open & emergency cases).
Discussion Laparoscopic Rt Hemi has advantage of minimal invasion, earlier recovery, lowere rates of wound complications, shorter hospital stay & comparable survival rates of Open Rt Hemi. The prolonged operative time is attributed to the use of laparoscopy. Em Rt Hemi had a poorer survival as patients were generally ill (ASA 3) with sepsis.
| Lap Rt Hemi (n=93) | Open Rt Hemi (n=118) | Em Rt Hemi (n =75) | Kruskal-Wallis test (p value) | |
| Age (yrs) | 74.8 | 72.3 | 70.0 | NS |
| Sex (M : F) | 41 : 52 | 67 : 51 | 33 : 42 | NS |
| ASA | 2 | 2 | 3 | < 0.05 |
| Weight (kg) | 67.6 | 80.4 | 68.6 | < 0.05 |
| BMI | 24.5 | 27.0 | 25.0 | < 0.05 |
| Appendix/Ileum | 1 | 2 | 1 | |
| Caecum | 51 | 60 | 32 | |
| Ascending colon | 22 | 23 | 12 | |
| Transverse colon | 19 | 33 | 30 | |
| Op time (min) | 145.8 | 107.1 | 118.6 | < 0.05 |
| LN harvest (n) | 16 | 16.5 | 14 | NS |
| Diverticulosis (n) | 14 | 14 | 13 | NS |
| Synchronous tumours (n) | 10 | 31 | 9 | < 0.05 |
| LOS (days) | 7 | 9 | 11 | < 0.05 |
| small bowel length (mm) | 92.2 | 92.7 | 124.1 | < 0.05 |
| large bowel length (mm) | 218.5 | 231.8 | 309.5 | NS |
| 1st year survival | 95.1 | 90.5 | 73.7 | logrank p < 0.05 |
| 3rd year survival | 82.2 | 76.5 | 49.9 | logrank p < 0.05 |
| 5th year survival | 69.4 | 71.7 | 45.4 | logrank p < 0.05 |